Individual
DESIRAE TERISSA MALAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 CENTER ST, CHICOPEE, MA 01013-2680
(413) 540-1234
Mailing address
10 CENTER ST, CHICOPEE, MA 01013-2680
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/15/2022
Last updated
05/15/2022
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